Hypermagnesemia in Emergency Medicine Workup

  • Author: Nona P Novello, MD; Chief Editor: Erik D Schraga, MD   more...
 
Updated: Jan 22, 2010
 

Laboratory Studies

  • Electrolytes, including potassium, magnesium, and calcium levels
    • A test for ionized magnesium is clinically available. However, it is used most often for monitoring magnesium infusions. The serum magnesium level is often used as an initial study in the ED.
    • Elevation in magnesium level is usually not found as an isolated electrolyte abnormality.
    • Hyperkalemia and hypercalcemia are often present concurrently.
  • BUN and creatinine levels
    • Obtain renal function tests and calculate creatinine clearance to assess the ability of the kidney to excrete magnesium.
    • Serum magnesium levels rise when creatinine clearance is less than 30 mL/min.
  • Check serum creatine phosphokinase (CPK) level or urine myoglobin level in patients in whom rhabdomyolysis is suspected.
  • Arterial blood gases (ABG) may reveal a respiratory acidosis.
  • Thyroid function tests
    • Hypothyroidism is a rare cause of hypermagnesemia.
    • Check these tests in the absence of any other good explanation.
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Other Tests

  • An ECG and cardiac monitor may show prolongation of the PR interval or intraventricular conduction delay, which are nonspecific findings.
  • The ECG findings may reflect other electrolyte abnormalities such as hyperkalemia.
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Contributor Information and Disclosures
Author

Nona P Novello, MD  Associate Chair, Department of Emergency Medicine, Franklin Square Hospital

Nona P Novello, MD is a member of the following medical societies: American College of Emergency Physicians and Phi Beta Kappa

Disclosure: Nothing to disclose.

Coauthor(s)

Howard A Blumstein, MD, FAAEM  Assistant Professor of Surgery, Medical Director, Department of Emergency Medicine, Wake Forest University School of Medicine

Howard A Blumstein, MD, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, Emergency Medicine Residents Association, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Joseph J Sachter, MD, FACEP  Consulting Staff, Department of Emergency Medicine, Muhlenberg Regional Medical Center

Joseph J Sachter, MD, FACEP is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American College of Physician Executives, American Medical Association, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Jeffrey L Arnold, MD, FACEP  Chairman, Department of Emergency Medicine, Santa Clara Valley Medical Center

Jeffrey L Arnold, MD, FACEP is a member of the following medical societies: American Academy of Emergency Medicine and American College of Physicians

Disclosure: Nothing to disclose.

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Erik D Schraga, MD  Staff Physician, Department of Emergency Medicine, Mills-Peninsula Emergency Medical Associates

Disclosure: Nothing to disclose.

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